Assessment of patterns and factors associated with inappropriate polypharmacy practice at Muhimbili National Hospital

Abstract

ABSTRACT Background: Polypharmacy involves the use of multiple medications by a single individual, often due to multiple medical conditions or symptoms. Inappropriate polypharmacy occurs when a patient is prescribed multiple medications that are either unnecessary or potentially unsafe. Inappropriate polypharmacy can lead to adverse drug reactions, decreased adherence, morbidity, mortality, and increased healthcare costs. Despite global concerns about its adverse effects, the indications, magnitude, involved medical conditions, and patient factors associated with inappropriate polypharmacy Tanzania. Objective: To assess patterns and factors associated with polypharmacy at Muhimbili National Hospital. Materials & Methods: A cross-sectional study design was employed. Prescriptions of 682 patients who received treatment at Muhimbili National Hospital from January 2023 to June 2023 were reviewed using a random probability sampling technique. Descriptive statistics were used to assess the magnitude of inappropriate polypharmacy, identify involved medical conditions, and identify patterns. Logistic regression was used to determine the associations between patient factors, provider factors and inappropriate polypharmacy. Results: More than half of the patients were female (58.4%), and 65.3% were adults aged 18 64. Most patients (67.2%) used insurance. Inappropriate polypharmacy occurred in 46.5% of cases. Higher risks were noted in females (aOR: 1.14,), adults aged 16-64 (aOR: 1.3), and insured patients (aOR: 1.16), while those with multi-morbidity had a lower risk (aOR: 0.59). Opioids & Narcotics were the most common drugs with addiction risks. Conclusions and recommendations: Inappropriate polypharmacy is a significant issue, especially among females, adults, and insured patients, often linked to conditions like obstetrics and gynecology, oncologic, and cardiovascular diseases. To improve patient safety and medication use, the study recommends strict adherence to prescribing guidelines, regular medication reviews by multidisciplinary teams, and promotion of collaborative care models. These steps aim to reduce unnecessary or harmful medication use and enhance patient outcomes.